NPI 1912510074 · live from the CMS NPI Registry
Boost Behavioral Services LLC
Behavior Analyst in Beaufort, SC. National Provider Identifier 1912510074, active.
NPI record
| NPI | 1912510074 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 14b Marshellen Dr, Beaufort, SC 29902 |
| Practice phone | 843-400-4581 |
| Mailing address | 174 James St, Beaufort, SC 29902 |
| Enumerated | August 28, 2020 |
| Last updated | September 24, 2020 |
| Authorized official | Kelsey Freeze, Owner |
| Other names | Boost Behavioral Services LLC |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.